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MD3001 - Respiratory Clinical > ABCDE Approach > Flashcards

ABCDE Approach Flashcards

1
Q

Give the observation, examination and actions of A

A

O = none

E = look, listen, feel for 10sec

A = ensure airway is patent

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2
Q

Give the observation, examination and actions of B

A

O = respiratory rate and SpO2

E = inspect, palpate, percuss, auscultate. Examine trachea and apex beat

A = oxygen; if tension pnemothorax decompress it

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3
Q

Give the observation, examination and actions of C

A

O = HR, BP, 3 lead ECG monitor

E = cap refill, skin temperature

A = IV access +/- fluids

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4
Q

Give the observation, examination and actions of D

A

O = glucose

E = AVPU, pupils

A = glucose replacement

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5
Q

Give the observation, examination and actions of E

A

E = full head to toe examination

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6
Q

What does ABCDE stand for?

A

A = Airway

B = Breathing

C = Cardiac

D = Diasbility

E = Exposure/Everything else

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7
Q

What are the first steps carried our prior to ABCDE?

A
  • personal safetly - gloves and apron
  • Critically ill patient - CALL FOR HELP
  • Ask the patient how they feel - response = patent airway
  • Look, listen feel
  • Unconcious and not breathing - start CPR
  • Monitor vital signs early
    • take bloods by inserting an intravenous catheter
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8
Q

When would you use the ABCDE approach?

A
  • appears unwell or is unresponsive
  • acute physiological derangement on basic observations
  • features of a serious acute problem in any organ system
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9
Q

What are the main components of A?

A
  • Ask how they are feeling
    • if they respond move straight to B
  • Asses airway for obstruction
    • lack of airflow in mouth (complete obstruction)
    • throat or tongue swelling
    • gurgling, snoring, choking, stridor
    • paradoxical breathing (indrawing of chest with expansion of abdomen on inspiration)
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10
Q

What are the main components of B?

A
  • high concentrations of O2 given if they are hypoxaemic
  • Assess rate, depth and symmetry of breathing:
    • poor resp effort = reduced rate, feeble, shallow breaths
    • high resp effort = high rate, use of accessory muscles, visibly tiring
    • asymmetrical chest expansion
  • check tracheal deviation
  • percuss and asculate chest
  • Record SpO2
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11
Q

How to respond in A if there are signs of obstruction

A
  • Get help
  • head tilt/chin lift or Jaw thrust
  • remove foreign bodies/secretions from pharynx under direct vision
  • insert guedel or nasopharyngeal airway
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12
Q

How to respond to A if obstruction persists despite efforts

A
  • Get expert assistance immediately
  • consider laryngeal mask airway or tracheal intubation
  • in anaphylaxis (thorat/tongue swelling), give IM adrenalune (0.5mg)
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13
Q

How to respond to B if respiratory effort is inadequete?

A
  • Get help
  • Manually ventilate via bag-valve-mask
  • Consider naloxone, if any suspicion of opiate toxicity
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14
Q

How to respond to B if there are signs of severe respiatory distress and signs of tension pneumothorax

A

aspirate immediately with a needle

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15
Q

What to check for if there are signs of widespread wheeze

A

check for anaphylaxis

If present manage appropraitely and if not give a nebulised bronchodialtor

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16
Q

What should the SpO2 of a patient with type 2 respiratory failure be?

A

88-92%

17
Q

What does dullness on percussion suggest?

A

pleural effusion, collapse or consolidation

18
Q

What do decreased breath sounds suggest?

A

collapse, pneumothorax, pleural effusion

19
Q

What does wheeze suggest?

A

bronchospasm

20
Q

What do crackles in the lungs suggest?

A

pulmonary oedema, fibrosis, consolidation

21
Q

What does bronchial breathing suggest?

A

consolidation

22
Q

What are the 8 components of C?

A
  1. check colour and temperature of hands
  2. Capillary refill time
  3. palpate radial and carotid pulse
  4. measure blood pressure
  5. assess height of JVP at 45degrees
  6. Ausculate heart for: murmurs and 3rd heart sound/gallop rhythm
  7. Attach ECG monitor and assess rhythm
  8. Perform 12-lead ECG if chest pain or arrhythmia
23
Q

What is a normal capillary refill time?

A
  • < 2 sec = NORMAL
  • > 2 sec = decreased peripheral perfusion
24
Q

What does a thready and weak pulse suggest?

A

decreased CO - hypovolemia

25
Q

What does a boudning heart rate suggest?

A

hyperdynamic circulation - early sepsis

26
Q

What action should be taken with patients showing signs of shock?

A

Secure IV access (large bore if possible)

27
Q

How do you treat ventricular tachycardia?

A

attempt defibrillation with synchronised DC shock

28
Q

How to treat bradycardia?

A

Atropine 0.5-3mg

If no effect cinsider IV adrenaline or transcutaneous pacing

29
Q

How to treat anaphylaxis

A
  • stop potential trigger
  • give 0.5mg IM adrenaline (anterolateral aspect of middle 1/3 of thigh
  • Give fast IV fluids
  • Get immediate anaethetic help
30
Q

Name some possible abnormalities of an ECG

A
  • Regular broad complex tachycardia - ventricular tachycardia
  • Regular narrow complex tachycardia - sinus tachycardia, supraventricular tachycardia, atrial flutter
  • Irregular tachycardia - atrial fibrilation
  • Bradycardia - 2nd or 3rd degree AV block
31
Q

What 4 things should be check in D?

A
  1. Capillary blood glucose
  2. Glasgow Coma Scale
  3. 3D history
  4. Examine pupils with pen torch
32
Q

Action if CBG <3mmol/L

A
  • Send blood to lab for measurement
  • Give immediate IV dextrose
33
Q

Action if the patient has a reduced glasgow coma score

A
  • perform ABG if any suspicion of hypercapnia
  • Give 08-2mh of naloxone if there is decreased pupil size or no obvious cause
  • Assess response after 1 min and consider further doses if partial response
34
Q

What is a 3D history?

A

Description of symptoms

Drugs and allergies

Disorders/Disability prior to this illness

35
Q

What does bilateral pinpoint suggest?>

A

opiod intoxication or pontine leison

36
Q

What does bilateral dilation suggest?

A

cocaine/amphetamine or tricyclic antidepressant intoxication or atropine

37
Q

What does unilateral fixed pupils suggest?

A

increased intracanial pressyre or 3rd nerve palsy

38
Q

What three procedures should be carried our in E?

A
  1. Record body temp
  2. fully expose body looking for:
  • bleeding or injuries
  • rashes
  • jaundice
  • medic alert bracelet
  1. Examine abdomen for distension, tenderness, guarding, rigidity

MD3001 - Respiratory Clinical (7 decks)

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